On Negative Feedback

Negative feedback is something that we all encounter in our lives, both giving and receiving. Neither is easy and most kind people would rather give positive than negative feedback. There is value in learning to receive negative feedback in a postive way, no matter how clumsily it is delivered. Nurses Relations Article

There's being blunt, honest and plain spoken. There's saying what you mean and meaning what you say. There's giving it to you straight, not pulling punches and there's even being rude or brusque. But none of those things are mean, nasty or hateful. They're a communication style that not everyone is comfortable with receiving, but they're a legitimate communication style, and people who communicate in that manner probably are not out to get you. They're just being straightforward, not beating around the bush and not sugar coating anything. Not every interaction you find unpleasant is mean, nasty, hateful or (and I hate to even bring up the word) bullying.

Most of us would rather receive negative feedback, if we have to receive it at all, from someone who is very skilled at making us feel good while delivering the criticism. Unfortunately, there just aren't that many of us who are so skillful and capable at the art of delivering negative feedback. Some wrap it up in rainbows or sugar coat it until it's unrecognizable as criticism. Others are more direct.

There are definite advantages to working with someone who says what they mean and means what they say. If they're your preceptor, you don't ever have to worry about what they're thinking. You KNOW when you've screwed up, HOW you screwed up and what you need to do not to screw up next time. They're not the preceptor who is blowing fairy dust up your skirt while writing the memo to the manager about how you're just not catching on and probably are not going to fit in or work out.

They're the preceptor who tells you "You got the time management thing nailed, but you really should not have given the Coumadin to the man with the cherry red urine, the INR of 7 and the hemoglobin of 6. Your critical thinking needs work."

(Or, more likely, "Your critical thinking is showing improvement and you were right not to give that Coumadin, but your meds are still two hours behind and your charting is at least four hours late.")

Some folks would like all of their negative feedback wrapped in rainbows and sandwiched in between praise and compliments -- and some of those folks actually hear and process the negative feedback packaged that way. But all too many folks hear the praise and compliments which reinforce their opinion that they're doing just great and the negative feedback just whooshes over their heads.

Those are the people who sign the performance improvement tool, certain that it really isn't that big of a deal because didn't they just tell you that you're obviously very smart and trying very hard?

And then they're completely taken aback when someone calls them to a meeting to discuss their options -- quit, be fired or transfer to a "less acute area."

Most good people, nice people, kind people hate to give negative feedback, and some try so hard to give it in a positive manner that the negative gets entirely lost. Some folks sugar coat the criticism so much it could pass as candy rather than criticism. Some folks are so nervous about giving negative feedback that it comes out far harsher than they intended, or even than they realize.

Most of us can benefit from hearing negative feedback, whether we find the experience pleasant or not. And negative feedback that is given in a direct, straightforward fashion has more chance of being understood and processed than negative feedback that is disguised as fairy dust and rainbows.

Negative feedback is not usually mean, nasty or hateful. It is, if you make it so, a wonderful tool for learning and improving your practice, for making your patients safer and your unit a better place to work. And isn't that what we're all really after?

Specializes in med surge.

That's all us new grads ask. ?

Specializes in LTC, assisted living, med-surg, psych.

Sometimes, the art of diplomatically giving someone criticism is much like telling them to go to hell, while at the same time ensuring that they enjoy the trip.:yes:

I personally always cringe at hearing negative feedback. I take it very personally - blame it on the desire to be a perfectionist in all things. I know that it results in correcting or improving my personal skills and attitudes. Doesn't mean I like it.

I'm the same way. I hate finding out I'm not perfect. :) But I realize it's a necessity in life. So I don't whine about it. Well, I try not to.

Specializes in Float Pool-Med-Surg, Telemetry, IMCU.

No one gives me as harsh criticism as I give myself. I am painfully aware of my faults and tend to beat myself up a lot. I recently got a good review and was surprised; I had gone into the manager's office like I was expecting to face a firing squad. :-)

I love this post, and completely agree. I see so many posts on here with people demanding only "constructive criticism." In my opinion, if you learn something, even if that something is to never do that thing again, it was constructive.

If you receive a criticism directly from your preceptor, that means he/she cares about your success, regardless of the manner in which it was delivered.

I haven't read any of the other responses, but as a behaviorist, I'm cringing at the use of the term "negative feedback" here.

Aside from that, sometimes I feel that people who defend their insensitive behavior by saying something like "Well, I just tell it like it is", or "I don't sugar coat" are really just excusing their own lack of tact, empathy, or sensitivity to another's feelings.

One can tell another person what they're doing wrong without being a jerk about it.

Specializes in Stepdown . Telemetry.

The experience I had as a new grad was not 5:1 pos to neg, or 3:1. It was more like, 4:1- with 4 neutral interactions to 1 negative. By neutral i mean my preceptor would simply concur with my care, and when i messed up i would hear about it. Then every so often i would get a specific positive. But for the most part, no specific feedback was the positive.

I remember feeling desperate for positive words to counteract my own sensitivity to negatives, but i learned to adapt to this style, where negative was bad, neutral was good, and a positive here and there was great.

If it had been 4 negatives to one neutral and zero positives, then this would be a problem. Had a teacher like this in school and it was horrible.

So new grads really can benefit from exploring their own sensitivity, if they are prone to it. I am the better for it.

I haven't read any of the other responses, but as a behaviorist, I'm cringing at the use of the term "negative feedback" here.

Aside from that, sometimes I feel that people who defend their insensitive behavior by saying something like "Well, I just tell it like it is", or "I don't sugar coat" are really just excusing their own lack of tact, empathy, or sensitivity to another's feelings.

One can tell another person what they're doing wrong without being a jerk about it.

You're completely right, a lot of people do use those phrases to justify their unnecessarily callous behavior. Not only is being rude unprofessional, it's counterproductive.

What is bothersome to me, is the accumulating number of posts I see of new grad nurses interpreting the no-nonsense attitude of their coworkers as straight up meanness and/or hatred, and the constant emphasis on "constructive criticism."

There are so many complaints about only hearing about mistakes, and nobody ever mentioning what they're doing right, and the whining is annoying. Although, I think it's safe to assume that this is the first venture into the adult world for most of these people, I'm sure they will eventually come to terms with the fact that you don't get special recognition for showing up and doing your job right.

Also, just curious...what's a behaviorist?

You're completely right, a lot of people do use those phrases to justify their unnecessarily callous behavior. Not only is being rude unprofessional, it's counterproductive.

What is bothersome to me, is the accumulating number of posts I see of new grad nurses interpreting the no-nonsense attitude of their coworkers as straight up meanness and/or hatred, and the constant emphasis on "constructive criticism."

There are so many complaints about only hearing about mistakes, and nobody ever mentioning what they're doing right, and the whining is annoying. Although, I think it's safe to assume that this is the first venture into the adult world for most of these people, I'm sure they will eventually come to terms with the fact that you don't get special recognition for showing up and doing your job right.

Agree. Praise for just showing up is not necessary to be tactful. It's not lacking in tact for me to not say to a new coworker, "You showed up on time!!! Yayyyyy!!!!" and then mentally checklist a +1 for positive feedback. Sometimes you aren't doing things that merit "positive feedback." I'd say usually, none of us are doing "positive" things a majority of the time but rather neutral. Doing your job satisfactorily isn't deserving of praise, it's what you're showing up and being paid to do. It's the bare minimum! And if you don't do 4,5,6 good things before you do a bad thing, then you don't deserve the recommended ratio of positive to negative feedback.

But if someone insists on it: I get paid by the hour. In 15 minute increments. My coworkers do the same. So there's some positive feedback 4x an hour. That means I can say nothing to you except negative feedback as long as I don't do it more often than 6 or 7 times in a 12 hour shift. Because our employer has supplied the positive feedback.

In the real world of paid employment, unless you work for Mary Poppins with unlimited spoonfuls of sugar, pay is about all you're going to get if doing your job right. Because my manager sure isn't showing up at midnight to heap 5 pieces of praise on me before writing me up for calling in to work last week. I do my job, I get paid. I do my job badly, I get critique. Guess what, new people are going to get pretty much the same, and need to learn that getting more "positive feedback" than your paycheck is gravy on the mashed potatoes of real life.

Also, just curious...what's a behaviorist?

What Is Behaviorism? (How It Works & Its Influence)

I love people who give it to you straight. Where there's no guessing where you stand. You hear the criticism and move on.

You're completely right, a lot of people do use those phrases to justify their unnecessarily callous behavior. Not only is being rude unprofessional, it's counterproductive.

What is bothersome to me, is the accumulating number of posts I see of new grad nurses interpreting the no-nonsense attitude of their coworkers as straight up meanness and/or hatred, and the constant emphasis on "constructive criticism."

There are so many complaints about only hearing about mistakes, and nobody ever mentioning what they're doing right, and the whining is annoying. Although, I think it's safe to assume that this is the first venture into the adult world for most of these people, I'm sure they will eventually come to terms with the fact that you don't get special recognition for showing up and doing your job right.

Also, just curious...what's a behaviorist?

There are tangible rewards and intangible rewards for showing up and doing your job. Tangible rewards are things like your paycheck. Intangible rewards might include camaraderie, a sense of accomplishment, the opportunity for growth, etc.

Everybody makes mistakes. Everybody- not just new grads. When in a supervisory role, one of your responsibilities is to provide feedback.

The manner in which you choose to provide that feedback does matter.

One can approach the new grad and say "You're too slow. You need to learn better time management. Everybody else is taking six patients and you're only taking three. Everybody's talking about it. You need to up your game or you're never going to make it around here."

Or, one can ask the new grad how they think things are going. Ask about their time management. Try to find out what is at the root of the problem, then give some feedback such as "At this point in your orientation, you should be able to handle a full patient load. What can we do to help you achieve this?"- and then actively involve the new grad in making a plan.

One could say to the new grad regarding a med error "I can't believe you did that. What on earth were you thinking? If this happens again, I'm going to have to let you go and report you to the BON."

Or, one could say "Mistakes happen and I'm glad nobody was harmed. What have you learned from this and how will you try to assure that this doesn't happen in the future?".

I see no virtue in "telling it like it is". To me, this is like saying that I'm just going to say what I think regardless of how it might impact the other person. Conversely, being direct is sometimes required, but can be done with sensitivity toward the other person. I think that when in a leadership role, the latter is the more appropriate approach.

I do agree that as adults in the workplace, not only are we responsible for how we give feedback, but we are also responsible for how we *receive* it. Sometimes it's not pleasant to hear about how we need to improve our performance, but we must be open to hearing it. I simply disagree that "not sugar coating" is of any greater value than delivering the same feedback in a respectful and tactful manner. If you are a supervisor and you don't feel like you are skilled in the latter, then maybe taking a class in interpersonal communication at your local community college would be helpful.